Beachcomber Care Home

Beachcomber Care Home is a residential care home providing accommodation and personal care for up to 48 people. At the time of our inspection there were 41 people using the service.

People’s experience of using this service and what we found

People living at Beachcomber Care Home told us they received safe care. Since the last inspection systems to monitor people’s safety had improved and risks were documented, although some inaccuracies were noted in the recording. Staff knew about current risks and how to respond. Concerns about people’s safety were acted on and staff knew how to raise safeguarding concerns. Medicines were managed safely. There was not always clear written guidance about topical and “as and when needed” medicines. This was corrected by the registered manager during this inspection. We observed safe staffing levels and received feedback from staff, relatives and people that there were enough staff to support people safely.

Staff had the necessary skills to carry out their roles. Staff had regular training and opportunities for supervision and observations of their work performance. People had access to healthcare services when they needed them. The home was clean, well maintained and people’s rooms were personalised.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. People were supported to eat varied and appropriate diets. People spoke positively about the food on offer.

The registered manager was supported by the provider and there were clear lines of responsibility in the home. Regular audits were taking place, but these were not consistently identifying and correcting inconsistency in records found at this inspection. Since the last inspection a new electronic care system had been introduced with a view to improving record keeping and oversight. The new system was not yet fully up to date and the new processes were not yet embedded. There were systems to learn and develop practice from concerns raised and management shared learning with staff. Staff worked with external social and health care professionals and we received positive feedback from agencies involved with the home.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk.

Rating at last inspection and update

The last rating for this service was requires improvement (published 02 November 2021) and there were breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

At our last inspection we recommended that the provider review staffing levels and practices around the Mental Capacity Act (MCA) and seek guidance on audits. At this inspection we found improvements had been made in relation to staffing levels and responding to the MCA. Some improvements had been made to audits but were still failing to identify all issues in the service.

Why we inspected

We carried out an unannounced comprehensive inspection of this service on 31 August 2021 and 01 September 2021. Breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by when to improve safe care and treatment.

We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe, Effective and Well-led which contain those requirements.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has changed from requires improvement to good. This is based on the findings at this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Beachcomber Care Home on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Beachcomber Care Home is a residential care home providing accommodation and personal care for up to 48 people. At the time of the inspection there were 47 people using the service. Accommodation is provided across two floors and there are a number of communal areas for people to use.

People’s experience of using this service and what we found

Risks to people were not always safely managed, monitored or assessed. There were enough staff to keep people safe, however, staff did not always have enough time to provide person-centred support. People’s personal care needs around bathing were not always fully met. We have made a recommendation around staffing levels.

People were not always supported to have maximum choice and control of their lives. Staff supported people in the least restrictive way possible and in their best interests, however, legal authorisation was not always in place to deprive people of their liberty to receive care and treatment. The procedures and systems in the service did not always support best practice in this area. We have made a recommendation around applications to deprive people of their liberty.

Based on our observations of the environment during the inspection, we found areas of concern regarding the homeliness and the atmosphere of the service. Management did not always promote a positive culture throughout the home. We received mixed feedback around staff morale and teamwork. Audits were not always effective. We have made a recommendation around audits.

People were protected from the risk of abuse and told us the staff were caring. Medicines were managed safely, and people received their medicines as prescribed. The service was preventing and controlling infection, and had managed well throughout the pandemic.

Staff had the right skills and knowledge to carry out their roles and received regular training, supervisions and appraisals. People were supported and encouraged to eat and drink, and people had access to enough food and drink throughout the day. People were referred to health professionals when required.

Management understood their regulatory responsibilities. Feedback was regularly sought from people, relatives, staff and professionals. Management was responsive to the issues we raised and immediately took action to make improvements.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was good (published 16 March 2018).

Why we inspected

We received concerns in relation to staffing levels, staff deployment, nutrition, personal care and management of the service. As a result, we undertook a focused inspection to review the key questions of safe, effective and well-led only.

We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.

We looked at infection prevention and control measures under the safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

The overall rating for the service has changed from good to requires improvement. This is based on the findings at this inspection.

We have found evidence that the provider needs to make improvement. Please see the safe, effective and well-led sections of this full report.

You can see what action we have asked the provider to take at the end of this full report.

Following the inspection, the provider has taken action to mitigate the risks. The provider was receptive to our feedback and has implemented new systems and procedures in response.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Beachcomber Care Home on our website at www.cqc.org.uk.

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service.

We have identified breaches in relation to safe care and treatment at this inspection.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Beachcomber Care Home is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Beachcomber Care Home accommodates 48 people with residential care needs across two floors. On the day of our inspection there were 43 people using the service. Facilities included several lounges, a dining room, communal bathrooms, shower rooms and toilets, a hairdressing room, a library and a well maintained communal courtyard.

The home had a registered manager in place. A registered manager is a person who has registered with CQC to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

Beachcomber Care Home was last inspected by CQC on 26 November 2015 and was rated Good. At this inspection we found the evidence continued to support the rating of ‘Good’ and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

The home was clean, spacious and suitable for the people who used the service. The provider had procedures in place for managing the maintenance of the premises and appropriate health and safety checks had been carried out.

Accidents and incidents were appropriately recorded and risk assessments were in place. The registered manager understood their responsibilities with regard to safeguarding and staff had been trained in safeguarding vulnerable adults.

Appropriate arrangements were in place for the safe management and administration of medicines.

The provider had an effective recruitment and selection procedure in place and carried out relevant checks when they employed staff. There were sufficient numbers of staff on duty in order to meet the needs of people who used the service.

Staff were supported to provide care to people who used the service through a range of mandatory and specialised training, supervision and appraisal. Staff said they felt supported by the registered manager.

People who used the service and their relatives were complimentary about the standard of care at Beachcomber Care Home.

Staff treated people with dignity and respect and helped to maintain people’s independence by encouraging them to care for themselves where possible.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible.

Care records showed people’s needs were assessed before they started using the service and care plans were written in a person centred way and were reviewed regularly. Person-centred is about ensuring the person is at the centre of any care or support and their individual wishes, needs and choices are taken into account.

People were protected from the risk of poor nutrition and staff were aware of people’s nutritional needs.

People had access to healthcare services and received ongoing healthcare support. Care plans were in place that recorded people’s plans and wishes for their end of life care.

Activities were arranged for people who used the service based on their likes and interests and to help meet their social needs, in the home and within the local community.

The provider had an effective complaints procedure in place and people who used the service and their relatives were aware of how to make a complaint.

The provider had an effective quality assurance process in place. People who used the service, relatives and staff were regularly consulted about the quality of the service through meetings and surveys.

the day of the inspection. Not everyone we spoke to could express their views, but those that could, told us they were very satisfied with the service they received. We found that people were involved in decisions about their care whenever possible.

We found assessment and support plans to help people stay as independent as possible. One person said, 'I just could not look after myself like this, so I am very grateful.'

Beachcomber had procedures in place to ensure that medicines were managed appropriately.

We found dedicated and qualified staff, whom had been recruited effectively. One new staff member told us, 'Security checks and references had to be completed before I was allowed to start work.'

We found that systems were in place to monitor the quality of service that people received, including for example; people and relative surveys. This showed that the provider sought the views of the people using its service.

The provider sent us an action plan following our visit. We returned to inspect again on 04 December 2012 to review improvements the provider had made.

We found people were cared for by staff who were supported to deliver care and treatment safely and to an appropriate standard.

People who used the service could be confident their personal records including medical records were accurate, held securely and remained confidential.

We spoke with a number of people who used the services at Beachcomber. One person said "I love it here' and another person said 'I'd be very disappointed if I had to move.' Other people we spoke with indicated to us they were happy to be living there.

People's needs were assessed and care and treatment was planned and delivered in line with their individual care plan. One person told us "The care is very good' and another person said 'You press your buzzer and they (the staff) are there in a matter of minutes.' Everybody we spoke with told us they felt safe at Beachcomber and with the care staff employed by the service.